Vision and Driving Difficulties with Nystagmus: Finding New Pathways

Singh, Neeraj Kumar; James, Ritika; Yadav, Avdhesh
August 2016
Optometry & Visual Performance;Aug2016, Vol. 4 Issue 4, p146
Academic Journal
Background: Nystagmus is an involuntary movement of the eyes in a rhythmic manner. Many individuals with this condition are visually impaired, some are registered blind, and very few can drive vehicles. It can severely disrupt quality of life, especially deteriorating confidence and self-esteem. The impact of nystagmus on driving performance can be severe and can disrupt visual sampling of the driving environment, interfere with driving behavior, and affect traffic safety. This can lead to fatal accidents both to an individual with nystagmus and to people on the road. Nystagmus reduces the overall quality of life, making it challenging and increasing dependence on others for routine activities. Despite this condition being one of the major causes of visual impairment globally, its impact on quality of life and driving difficulties has not been studied. The present study intended to assess these aspects of vision and driving difficulties and to codify rehabilitation measures in order to provide some relief to people with nystagmus and improve their daily living. Methods: The research was completed in two countries, India and the United Kingdom (UK), better to represent the wider population with nystagmus. A total of 79 Indian participants were included in the study: 42 with infantile nystagmus and 37 with acquired nystagmus. Quality of life was assessed through a standardized Health Related Quality of Life (HRQOL) Questionnaire, and vision-related quality of life (VR-QOL) was assessed through the Indian Vision Function Questionnaire. Twenty-four UK participants were recruited, and quality of life was assessed via questionnaire. Driving performance was assessed on 27 Indian participants (19 infantile, 8 acquired). Results: Quality-of-life assessment revealed that the major visual difficulties faced by both Indian and UK participants with nystagmus included difficulty with both distance and near vision, recognizing faces, focusing, oscillopsia, visual discomfort, and an overall reduction in near work. Driving was a major problem; forty-one percent (n=27) of overall participants could drive. Out of 27 participants assessed for driving, forty-one percent (n=11) passed, and fifty-two percent (n=14) failed. A negative correlation was found between visual acuity (logMAR) and VR-QOL, which was statistically significant (rs=-0.398, p=0.0001). Conclusion: Forty-one percent of our participants on whom a driving assessment was performed exhibited proficient on-road driving skills and passed the driving test. Hence, people with this condition can drive if they possess potential vision, and further training can improve their driving skills. Counseling sessions, yoked prisms, vision therapy, and occupational therapy training were effective in relieving the visual discomfort and providing an overall boost in self-esteem and confidence level for people with nystagmus.


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